Outcome of surgical management of carcinoma of the pancreas

Abstract

In our study the resectability rate was 25%. Management of the case depends upon the stage of the tumour at time of presentation. Surgical management is the best suitable with chance of curative resection of the tumour. Various modifications in pancreaticoduodenectomy have been done since the Whipple`s procedure was introduced. Pylorus preserving pancreaticoduodenectomy is one such modification. Pancreatic stump is associated most of the time with complications of leakage. Although the techniques of pancreaticoduodenectomy have been improved with better pre operative evaluation, anaesthetic facilities and post operative care of the patient, the long term five year survival is still not much increased. Moreover, post operative hospital stay and complication rate is still high. Alternatively, bypass procedure especially where the disease i s advanced and the tumour is not resectable, are applied. These palliative procedures are associated with short hospital stay, less post operative complications, early relief of symptoms and better quality of life. Short term survival is rather better in these patients as compared to those undergoing resection. Six months survival in our study was 66.6% as compared to 60% in resected cases. Supportive therapies including chemotherapy, radiotherapy and hormone therapy at present are not of much help.